Medical coding

1 week ago

Hyderabad Telangana India, Telangana Mancer Consulting Services Full time

We are seeking an experienced Coding Manager to lead our Coding Integrity, Coding Validation, and Clinical Documentation Improvement (CDI) operations. This role provides strategic leadership, drives quality and productivity, and ensures compliance with regulatory standards across all coding functions.

Key Responsibilities (not limited to)

Team Leadership & Oversight

  • Lead and manage Coding Integrity Specialists (CIS I–III), CARS (I–III), CDI Liaisons, Coding Leads, and Coding Mentors.
  • Provide guidance on work processes, quality standards, scheduling, productivity, and performance.
  • Coach, mentor, and develop team members; address performance issues when necessary.
  • Ensure team schedules and staffing align with SLAs and operational needs.
  • Coordinate ongoing training, education, and quality reviews for all direct reports.

Operational Excellence

  • Oversee the Coding Prebill Account Review Tool (CPART) and coding validation workflows.
  • Ensure accurate, complete, and compliant coding and DRG/code validation as per guidelines and policies.
  • Lead coding and CDI reconciliation activities and unbilled management workflows.
  • Monitor productivity, TAT, quality, and ensure proactive management of operational issues.
  • Review and enhance processes to improve service levels, accuracy, and cost efficiency.

Quality, Compliance & Reporting

  • Analyze coding data outcomes and Case Mix Index (CMI) trends to identify root causes and implement improvements.
  • Stay current with regulatory updates and ensure timely education across the team.
  • Prepare and present benchmarking, quality, productivity, and validation reports for leadership.
  • Ensure compliance with company/HSC policies, coding guidelines, workflow standards, and documentation requirements.

Cross-Functional Collaboration

  • Work closely with HSC Leadership, Shared Services Center teams, Facility and Market Leadership on coding accuracy, denials, medical necessity, and payment compliance.
  • Collaborate with multi-disciplinary teams to address documentation improvement opportunities.
  • Facilitate problem-solving and continuous improvement initiatives across departments.

Leadership & Strategy

  • Participate in developing strategy, goals, budgets, and performance standards for coding and CDI operations.
  • Report key issues, trends, and risks to leadership promptly.
  • Uphold and promote the organization’s Code of Conduct and Mission & Values.

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